{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T02:49:49Z","timestamp":1778640589492,"version":"3.51.4"},"reference-count":30,"publisher":"Walter de Gruyter GmbH","issue":"12","funder":[{"DOI":"10.13039\/501100001809","name":"National Science Foundation of China","doi-asserted-by":"crossref","award":["81872637, 81903341, 82173534"],"award-info":[{"award-number":["81872637, 81903341, 82173534"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Shanghai Professional and Technical Services Platform","award":["18DZ2294100"],"award-info":[{"award-number":["18DZ2294100"]}]},{"name":"Foundation of National Facility for Translational Medicine, Shanghai","award":["TMSK-2020-124"],"award-info":[{"award-number":["TMSK-2020-124"]}]},{"name":"Key Subject Program for Clinical Nutrition from Shanghai Municipal Health Commission","award":["2019ZB0103"],"award-info":[{"award-number":["2019ZB0103"]}]},{"name":"Key discipline construction project of the three-year action Plan of Shanghai Public Health System","award":["GWV-10.1-XK07"],"award-info":[{"award-number":["GWV-10.1-XK07"]}]},{"name":"Zhongshan City Social Welfare Science and Technology Research Project","award":["2019B1017"],"award-info":[{"award-number":["2019B1017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2021-0181_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>In this study, we evaluated the concordance between the ultrasonographic stage of breast (US B) and Tanner stage of breast (TS B) for overweight and obese girls based on a school population study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2021-0181_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted multistage, stratified cluster, and random-proportional sampling and ultimately included 221 girls (aged 6\u201310 years).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2021-0181_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>This study revealed that the concordance was poor (accuracy=0.19 (95% confidence interval: 0.14, 0.25)) between US B and TS B among the 221 participants. When our subjects were stratified by weight, we observed a weak association between US B and TS B in the thin\/normal weight group (r=0.34, p=0.001) but not in the overweight (r=0.097, p=0.38) or obese groups (r=\u20130.19, p=0.206), and as the body mass index (BMI) z-score increased, the overestimation ratio of TS B increased. US B manifested a positive correlation with breast bud diameter (BD) (r=0.885, p&lt;0.001), follicle-stimulating hormone (r=0.235, p=0.009), and luteinizing hormone (r=0.192, p=0.037), but this was not the case with TS B.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2021-0181_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>As the BMI z-score increased, the correlation between the two methods declined, and the overestimation ratio of TS B increased. US B is an objective and quantitative method used to evaluate breast development, and whether BD might replace US B as a routine diagnostic method to evaluate breast development in clinical practice needs to be confirmed in larger-sample studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2021-0181","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T21:22:31Z","timestamp":1631049751000},"page":"1549-1558","source":"Crossref","is-referenced-by-count":2,"title":["The concordance between ultrasonographic stage of breast and Tanner stage of breast for overweight and obese girls: a school population-based study"],"prefix":"10.1515","volume":"34","author":[{"given":"Dongxue","family":"Pan","sequence":"first","affiliation":[{"name":"The Second School of Clinical Medicine, Southern Medical University , Guangzhou City , Guangdong Province , P. R. China"},{"name":"BoAi Hospital of Zhongshan Affiliated to Southern Medical University , Zhongshan City , Guangdong Province , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simao","family":"Fu","sequence":"additional","affiliation":[{"name":"Zhongshan City People's Hospital of Sun-Yat-Sen University , Zhongshan City , Guangdong Province , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoqing","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai , P. R. China"},{"name":"Department of Clinical Epidemiology and Biostatistics , Children Health Advocacy Institute, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine , Shanghai , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai , P. R. China"},{"name":"Department of Clinical Epidemiology and Biostatistics , Children Health Advocacy Institute, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine , Shanghai , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sizhe","family":"Huang","sequence":"additional","affiliation":[{"name":"Health Care Center for Primary and Secondary Schools , Zhongshan City , Guangdong province , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bihong","family":"Zhang","sequence":"additional","affiliation":[{"name":"BoAi Hospital of Zhongshan Affiliated to Southern Medical University , Zhongshan City , Guangdong Province , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Lai","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine, Southern Medical University , Guangzhou City , Guangdong Province , P. R. China"},{"name":"BoAi Hospital of Zhongshan Affiliated to Southern Medical University , Zhongshan City , Guangdong Province , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifan","family":"Liu","sequence":"additional","affiliation":[{"name":"The Second School of Clinical Medicine, Southern Medical University , Guangzhou City , Guangdong Province , P. R. China"},{"name":"BoAi Hospital of Zhongshan Affiliated to Southern Medical University , Zhongshan City , Guangdong Province , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaodan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Developmental and Behavioral Pediatrics , Shanghai Children\u2019s Medical Center,School of Medicine, Shanghai Jiao Tong University , Shanghai , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuilan","family":"Lin","sequence":"additional","affiliation":[{"name":"BoAi Hospital of Zhongshan Affiliated to Southern Medical University , Zhongshan City , Guangdong Province , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7050-463X","authenticated-orcid":false,"given":"Shijian","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai , P. R. China"},{"name":"Department of Clinical Epidemiology and Biostatistics , Children Health Advocacy Institute, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine , Shanghai , P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,9,8]]},"reference":[{"key":"2023041309511314781_j_jpem-2021-0181_ref_001","doi-asserted-by":"crossref","unstructured":"Biro, FM, Greenspan, LC, Galvez, MP, Pinney, SM, Teitelbaum, S, Windham, GC, et al.. Onset of breast development in a longitudinal cohort. Pediatrics 2013;132:1019\u201327. https:\/\/doi.org\/10.1542\/peds.2012-3773.","DOI":"10.1542\/peds.2012-3773"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_002","doi-asserted-by":"crossref","unstructured":"Chen, C, Zhang, Y, Sun, W, Chen, Y, Jiang, Y, Song, Y, et al.. Investigating the relationship between precocious puberty and obesity: a cross-sectional study in Shanghai, China. BMJ Open 2017;7: e014004. https:\/\/doi.org\/10.1136\/bmjopen-2016-014004.","DOI":"10.1136\/bmjopen-2016-014004"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_003","doi-asserted-by":"crossref","unstructured":"Lian, Q, Mao, Y, Luo, S, Zhang, S, Tu, X, Zuo, X, et al.. Puberty timing associated with obesity and central obesity in Chinese Han girls. BMC Pediatr 2019;19:1. https:\/\/doi.org\/10.1186\/s12887-018-1376-4.","DOI":"10.1186\/s12887-018-1376-4"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_004","doi-asserted-by":"crossref","unstructured":"Eckert-Lind, C, Busch, AS, Petersen, JH, Biro, FM, Butler, G, Br\u00e4uner, EV, et al.. Worldwide secular trends in age at pubertal onset assessed by breast development among girls: a systematic review and meta-analysis. JAMA Pediatr 2020;174: e195881. https:\/\/doi.org\/10.1001\/jamapediatrics.2019.5881.","DOI":"10.1001\/jamapediatrics.2019.5881"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_005","doi-asserted-by":"crossref","unstructured":"Marshall, WA, Tanner, JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291\u2013303. https:\/\/doi.org\/10.1136\/adc.44.235.291.","DOI":"10.1136\/adc.44.235.291"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_006","doi-asserted-by":"crossref","unstructured":"Fugl, L, Hagen, CP, Mieritz, MG, Tinggaard, J, Fallentin, E, Main, KM, et al.. Glandular breast tissue volume by magnetic resonance imaging in 100 healthy peripubertal girls: evaluation of clinical Tanner staging. Pediatr Res 2016;80:526\u201330. https:\/\/doi.org\/10.1038\/pr.2016.125.","DOI":"10.1038\/pr.2016.125"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_007","doi-asserted-by":"crossref","unstructured":"Y\u00fcce, \u00d6, Sevin\u00e7, D. Ultrasonographic assessment of pubertal breast development in obese children: compliance with the clinic. J Pediatr Endocrinol Metab 2018;31:137\u201341. https:\/\/doi.org\/10.1515\/jpem-2017-0243.","DOI":"10.1515\/jpem-2017-0243"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_008","doi-asserted-by":"crossref","unstructured":"Bruni, V, Dei, M, Deligeoroglou, E, Innocenti, P, Bassi, F. Breast development in adolescent girls. Adolesc Pediatr Gynecol 1990;3:201\u20135. https:\/\/doi.org\/10.1016\/s0932-8610(19)80037-3.","DOI":"10.1016\/S0932-8610(19)80037-3"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_009","doi-asserted-by":"crossref","unstructured":"Calcaterra, V, Sampaolo, P, Klersy, C, Larizza, D, Alfei, A, Brizzi, V, et al.. Utility of breast ultrasonography in the diagnostic work-up of precocious puberty and proposal of a prognostic index for identifying girls with rapidly progressive central precocious puberty. Ultrasound Obstet Gynecol 2009;33:85\u201391. https:\/\/doi.org\/10.1002\/uog.6271.","DOI":"10.1002\/uog.6271"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_010","doi-asserted-by":"crossref","unstructured":"Carlson, L, Flores Poccia, V, Sun, BZ, Mosley, B, Kirste, I, Rice, A, et al.. Early breast development in overweight girls: does estrogen made by adipose tissue play a role? Int J Obes 2019;43:1978\u201387. https:\/\/doi.org\/10.1038\/s41366-019-0446-5.","DOI":"10.1038\/s41366-019-0446-5"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_011","doi-asserted-by":"crossref","unstructured":"Bruserud, IS, Roelants, M, Oehme, NHB, Madsen, A, Eide, GE, Bjerknes, R, et al.. References for ultrasound staging of breast maturation, Tanner breast staging, pubic hair, and menarche in\u00a0Norwegian Girls. J Clin Endocrinol Metab 2020;105:1599\u2013607. https:\/\/doi.org\/10.1210\/clinem\/dgaa107.","DOI":"10.1210\/clinem\/dgaa107"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_012","doi-asserted-by":"crossref","unstructured":"Liu, Y, Yu, T, Li, X, Pan, D, Lai, X, Chen, Y, et al.. Prevalence of precocious puberty among Chinese children: a school population-based study. Endocrine 2021;72:573\u201381. https:\/\/doi.org\/10.1007\/s12020-021-02630-3.","DOI":"10.1007\/s12020-021-02630-3"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_013","doi-asserted-by":"crossref","unstructured":"Cole, TJ, Flegal, KM, Nicholls, D, Jackson, AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 2007;28:335\u2013194. https:\/\/doi.org\/10.1136\/bmj.39238.399444.55.","DOI":"10.1136\/bmj.39238.399444.55"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_014","doi-asserted-by":"crossref","unstructured":"Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320:1240\u20133. https:\/\/doi.org\/10.1136\/bmj.320.7244.1240.","DOI":"10.1136\/bmj.320.7244.1240"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_015","unstructured":"World Health Organization. Growth Reference Data for Children From 5 to 19 Years, 2007. Geneva: WHO; 2007. Available from: http:\/\/www.who.int\/growthref\/en\/."},{"key":"2023041309511314781_j_jpem-2021-0181_ref_016","doi-asserted-by":"crossref","unstructured":"Garc\u00eda, CJ, Espinoza, A, Dinamarca, V, Navarro, O, Daneman, A, Garc\u00eda, H, et al.. Breast US in children and adolescents. Radiographics 2000;20:1605\u201312. https:\/\/doi.org\/10.1148\/radiographics.20.6.g00nv171605.","DOI":"10.1148\/radiographics.20.6.g00nv171605"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_017","doi-asserted-by":"crossref","unstructured":"Huen, KF, Leung, SS, Lau, JT, Cheung, AY, Leung, NK, Chiu, MC. Secular trend in the sexual maturation of southern Chinese girls. Acta Paediatr 1997;86:1121\u20134. https:\/\/doi.org\/10.1111\/j.1651-2227.1997.tb14820.x.","DOI":"10.1111\/j.1651-2227.1997.tb14820.x"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_018","doi-asserted-by":"crossref","unstructured":"Ma, HM, Du, ML, Luo, XP, Chen, SK, Liu, L, Chen, RM, et al.. Onset of breast and pubic hair development and menses in urban Chinese girls. Pediatrics 2009;124:e269\u2013277. https:\/\/doi.org\/10.1542\/peds.2008-2638.","DOI":"10.1542\/peds.2008-2638"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_019","doi-asserted-by":"crossref","unstructured":"Sun, Y, Tao, FB, Su, PY, Mai, JC, Shi, HJ, Han, YT, et al.. National estimates of the pubertal milestones among urban and rural Chinese girls. J Adolesc Health 2012;51:279\u201384. https:\/\/doi.org\/10.1016\/j.jadohealth.2011.12.019.","DOI":"10.1016\/j.jadohealth.2011.12.019"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_020","doi-asserted-by":"crossref","unstructured":"Li, W, Liu, Q, Deng, X, Chen, Y, Yang, B, Huang, X, et al.. Association of prepubertal obesity with pubertal development in Chinese girls and boys: a longitudinal study. Am J Hum Biol 2018;30: e23195. https:\/\/doi.org\/10.1002\/ajhb.23195.","DOI":"10.1002\/ajhb.23195"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_021","doi-asserted-by":"crossref","unstructured":"Li, W, Liu, Q, Deng, X, Chen, Y, Liu, S, Story, M. Association between obesity and puberty timing: a systematic review and meta-analysis. Int J Environ Res Publ Health 2017;14:1266. https:\/\/doi.org\/10.3390\/ijerph14101266.","DOI":"10.3390\/ijerph14101266"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_022","unstructured":"Motlagh, ME, Rabbani, A, Kelishadi, R, Mirmoghtadaee, P, Shahryari, S, Ardalan, G. Timing of puberty in Iranian girls according to their living area: a national study. J Res Med Sci 2011;16:276\u201381."},{"key":"2023041309511314781_j_jpem-2021-0181_ref_023","doi-asserted-by":"crossref","unstructured":"Harley, KG, Berger, KP, Kogut, K, Parra, K, Lustig, RH, Greenspan, LC, et al.. Association of phthalates, parabens and phenols found in personal care products with pubertal timing in girls and boys. Hum Reprod 2019;34:109\u201317. https:\/\/doi.org\/10.1093\/humrep\/dey337.","DOI":"10.1093\/humrep\/dey337"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_024","doi-asserted-by":"crossref","unstructured":"Youn, I, Park, SH, Lim, IS, Kim, SJ. Ultrasound assessment of breast development: distinction between premature thelarche and precocious puberty. Am J Roentgenol 2015;204:620\u20134. https:\/\/doi.org\/10.2214\/ajr.14.12565.","DOI":"10.2214\/AJR.14.12565"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_025","doi-asserted-by":"crossref","unstructured":"Bruserud, IS, Roelants, M, Oehme, NHB, Eide, GE, Bjerknes, R, Rosendahl, K, et al.. Ultrasound assessment of pubertal breast development in girls: intra-and interobserver agreement. Pediatr Radiol 2018;48:1576\u201383. https:\/\/doi.org\/10.1007\/s00247-018-4188-7.","DOI":"10.1007\/s00247-018-4188-7"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_026","doi-asserted-by":"crossref","unstructured":"Venta, LA, Dudiak, CM, Salomon, CG, Flisak, ME. Sonographic evaluation of the breast. Radiographics 1994;14:29\u201350. https:\/\/doi.org\/10.1148\/radiographics.14.1.8128064.","DOI":"10.1148\/radiographics.14.1.8128064"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_027","doi-asserted-by":"crossref","unstructured":"Valeur, NS, Rahbar, H, Chapman, T. Ultrasound of pediatric breast masses: what to do with lumps and bumps. Pediatr Radiol 2015;45:1584\u201399. https:\/\/doi.org\/10.1007\/s00247-015-3402-0.","DOI":"10.1007\/s00247-015-3402-0"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_028","doi-asserted-by":"crossref","unstructured":"Neely, EK, Wilson, DM, Lee, PA, Stene, M, Hintz, RL. Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty. J Pediatr 1995;127:47\u201352. https:\/\/doi.org\/10.1016\/s0022-3476(95)70255-5.","DOI":"10.1016\/S0022-3476(95)70255-5"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_029","doi-asserted-by":"crossref","unstructured":"Houk, CP, Kunselman, AR, Lee, PA. Adequacy of a single unstimulated luteinizing hormone level to diagnose central precocious puberty in girls. Pediatrics 2009;123:1059\u201363. https:\/\/doi.org\/10.1542\/peds.2008-1180.","DOI":"10.1542\/peds.2008-1180"},{"key":"2023041309511314781_j_jpem-2021-0181_ref_030","doi-asserted-by":"crossref","unstructured":"Vurall\u0131, D, G\u00f6n\u00e7, EN, \u00d6z\u00f6n, ZA, Alika\u015fifo\u011flu, A. Adequacy of basal luteinizing hormone levels in the diagnosis of central precocious puberty. Turk Pediatri Ars 2020;55:131\u20138. https:\/\/doi.org\/10.14744\/TurkPediatriArs.2019.03708.","DOI":"10.14744\/TurkPediatriArs.2019.03708"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2021-0181\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2021-0181\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T12:07:18Z","timestamp":1681387638000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2021-0181\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,8]]},"references-count":30,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,9,8]]},"published-print":{"date-parts":[[2021,12,20]]}},"alternative-id":["10.1515\/jpem-2021-0181"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2021-0181","relation":{},"ISSN":["0334-018X","2191-0251"],"issn-type":[{"value":"0334-018X","type":"print"},{"value":"2191-0251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,8]]}}}